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Page 1 of 4 International Affairs Office
King Mongkut’s University of Technology Thonburi (KMUTT) 126 Pracha Uthit Rd., Bang Mod, Thung Khru,
Bangkok 10140 THAILAND Email: [email protected]
Tel: +66 2 470 8342, +66 2 470 8344
Application Form for Non-Regular Students
PERSONAL INFORMATION
Title: (Mr./Ms./Mrs)
Given Name:
Middle Name: (If any)
Family Name:
Passport: Expiry date: (DD/MM/YYYY)
Nationality: Date of Birth: (DD/MM/YYYY)
Native language: English Other: Please specify
For non-native speaker of English, please specify your English test score
TOEFL: score TOEIC: score
IELTS: score Others: score
Allergy:
Email Address:
Phone Number:
Photo
Page 2 of 4 International Affairs Office
King Mongkut’s University of Technology Thonburi (KMUTT) 126 Pracha Uthit Rd., Bang Mod, Thung Khru,
Bangkok 10140 THAILAND Email: [email protected]
Tel: +66 2 470 8342, +66 2 470 8344
Application Form for Non-Regular Students
ACADEMIC INFORMATION
Home Institution:
Country:
Level: Bachelor’s Degree Master’s Degree Doctoral Degree
Field/Program of Study:
Name of Coordinator:
Email Address:
APPLICATION FOR
Semester: 1st semester (Aug.-Dec.)
2nd semester (Jan.-May)
Summer session (Jun.-Jul.)
Begin Date: (DD/MM/YYYY)
End Date: (DD/MM/YYYY)
Type: Semester Exchange
Non-degree
Internship
Short-term Activity: Please specify
Research: Entitled
Faculty/School at KMUTT: Choose an item.
Field/Program of Study at KMUT:
Page 3 of 4 International Affairs Office
King Mongkut’s University of Technology Thonburi (KMUTT) 126 Pracha Uthit Rd., Bang Mod, Thung Khru,
Bangkok 10140 THAILAND Email: [email protected]
Tel: +66 2 470 8342, +66 2 470 8344
Application Form for Non-Regular Students
EMERGENCY CONTACT
Name-Surname:
Relation:
E-mail address:
Phone number:
Country:
IF YOU ARE ACCEPTED TO KMUTT
1. You are going to apply for student visa at Royal Thai Embassy/Consulate in
City/State:
Country:
(See more details at http://www.thaiembassy.org/main/)
2. We shall send a Letter of Acceptance (LoA) and a supporting letter for your visa application to the following address for correspondence. ( For semester exchange students, the letters will be sent to your coordinator at your home institution so please provide the coordinator’s name and your home institution address ).
Name-Surname:
Address:
City/State:
Country:
Postal code:
DECLARATION: I declare that the above information is true. I understand that the University reserves the right to vary or reverse any decision regarding admission or enrolment made on the basis of incorrect information.
Applicant’s Name/Signature Date
Page 4 of 4 International Affairs Office
King Mongkut’s University of Technology Thonburi (KMUTT) 126 Pracha Uthit Rd., Bang Mod, Thung Khru,
Bangkok 10140 THAILAND Email: [email protected]
Tel: +66 2 470 8342, +66 2 470 8344
Application Form for Non-Regular Students
Checklist of requirements
No. Document Exchange Non-degree Internship Short-term
Activity Research
1 Letter of Nomination issued by your institution
2 Completed application form
3 Learning agreement
4 A copy of transcript
5 English language proficiency test or Recommendation Letter (for non-native speaker of English)
6 Portfolio with explanation about your interested research area
7 A medical certificate issued not before 1 month prior to application date
8 A readable copy of passport (valid for not less than 6 months from the date of arrival in Thailand and blank pages)
9 Course syllabus from Home University
Note: Please combine the application and other documents into (1) pdf file named
(your name).pdf in case of applying by email. Please submit all required application documents EITHER
By email to [email protected]
OR By mailing to International Affairs Office King Mongkut’s University of Technology Thonburi 126 Pracha-u-thit Road, Bangmod, Thungkru, Bangkok 10140 THAILAND Tel: +66 2470-8342, +66 2470-8344, +66 2470-8346 Fax: +66 2470-8346
